On the faculty in Melbourne
A/Prof Kenneth Cutbush attended the Asia Pacific Orthopaedic Association (APOA) Congress in Melbourne as faculty. He presented on "New and evolving arthroscopic techniques in shoulder instability" and chaired the session "Shoulder Instability: Options & Best Practice".
Pictured, from left to right: A/Prof Kenneth Cutbush, Prof Richard Page, Dr Greg Hoy, Dr Deepak Bhatia and Dr Merter Ozenci.
What the Asia Pacific Orthopaedic Association is
The Asia Pacific Orthopaedic Association is a regional body that brings together the national orthopaedic associations of countries across Asia and the Pacific. Its congress is a general orthopaedic meeting, covering the whole musculoskeletal system, and it runs sessions on each subspecialty in parallel.
A regional congress does something that neither a national meeting nor a world congress does particularly well. The countries represented differ widely in resources, in the injuries their populations present with, and in what implants and imaging are available, so a technique that is routine in one member country may be impractical in another. Sessions are built around faculty from several of those countries so that the discussion has to account for those differences, and the chair's job is largely to keep it honest about them. Faculty are invited to present and to chair; chairing a session means framing the topic, keeping the papers to time and steering the discussion afterwards.
Shoulder instability and the arthroscopic options
Shoulder instability means the joint does not stay reliably in place. The ball of the upper arm bone sits against a shallow socket, which is what allows the shoulder its range of movement, and it is held there by a rim of cartilage called the labrum, by the capsule and ligaments around it, and by the muscles. A dislocation tears some of those structures, and once they are torn the shoulder can dislocate again more easily, sometimes with progressively less force.
Surgery aims to restore the structures that have failed. Where the labrum and capsule have detached, they can be reattached to the rim of the socket with small anchors. Where bone has been lost from the front of the socket, a bone block procedure such as a Latarjet replaces it. Where a dent in the back of the ball is engaging on the socket rim, a remplissage fills it. Most of these can now be performed through the arthroscope, working through small incisions with a camera, which is the subject the session covered. Which option suits a given shoulder depends on the pattern of damage. Individual results vary.
Related information
- The shoulder instability page, and the anterior instability page.
- The arthroscopic Bankart repair page.
- The Latarjet and labral repair page.
- The remplissage page.